Rs.125/- ORIGINAL TRIBAL WELFARE DEPARTMENT RECRUITMENT FOR THE POST OF HOSTEL WELFARE OFFICER Gr-II (Women only on Regular basis) (ICR Application form for Computerization Purpose) Application Number (Office use to be filled by the verification officer) District Code (To be filled by the Candidate as per the Instructions given on the backside of this sheet) 01. Category of the Post 02. Surname Name 03. Father's Name 04. Postal Address Day Month Year Months Years 05. Date of Birth Age: 06. Sex 07. Community 08. Local / Non Local 09. Handicapped Status percentage 10. Education Qualifications: (A) General qualification: (B) Professional Qualification: 11. Experience and Extra Curricular activity if any: 12. Weightage marks: a) Experience b) Games & Sports: c) NSS : d) NCC: 13. Examination: (Date, Time and Center name will be communicated through Hall Ticket) 14. Particulars of D.D.(Rs.125/-) DD. No. Dated. Drawn on which bank I hereby declare that the information furnished here is true and shall be liable for any false information. I hereby declare that all information furnished by the candidate is checked by me and found correct Full signature of the applicant within the box Signature of the Verification officer within the box Date: Date: Paste the latest Pass Port Size photograph strictly within the dotted lines only. Do not staple/ pin or do not sign on the photograph 0 1 F PIN Code -11-2007 Instructions for fillingup of ICR APPLICATION FORM FOR COMPUTERIZATION PURPOSE 1. The original application form for computerization purpose shall be handled carefully. It should not be mutilated or folded. Mutilated or folded forms will not be accepted. 2. All the enclosures should be tagged or stapled ONLY TO THE DUPLICATE APPLICATION 3. Applications should be filled properly and legibly by the candidate in his/ her own handwriting with ball pen blue or black in CAPITAL LETTERS only. 4. Please do not overwrite on the original application form. Candidates are advised to make use of the specimen copy of the application form (furnished in the application set) before filling the original ICR application form for computerization purpose. After making sure that the entries made in the specimen are correct. The same can b transferred on to the original form. 5. Only good quality black and white passpost size photograph should be pasted on the original form. Please do not staple or pin the photograph. Please do not sign on the photograph. 6. Only codes should be entered in the boxes provided against items 01,02,03,08,09,10,11 and 12 in the application form. 7. D.D. Rs. 125/- drawn infavour of Asst. Accounts Officer, O/o Director of Tribal Welfare, A.P., Hyderabad (Except in case of SCs / STs) . District Code - 04. East Godavari 09. Nellore 14. Mahaboobnagar 19. Adilabad Code 05. West Godavari 10. Chittoor 15. Ranga Reddy 20. Karimnagar 01. Srikakulam 06. Krishna 11. Kadapa 16. Hyderabad 21. Warangal 02. Vizianagaram 07. Guntur 12. Anantapur 17. Medak 22. Khammam 03. Visakhapatnam 08. Prakasam 13. Kurnool 18. Nizamabad 23. Nalgonda 01. Category of the Hostel Welfare Officer Gr.II 06. Sex Code 07. Community Code Code 1 - OC 5 - BC-D 01 - Regular 2 - BC-A 6 - SC 3 - BC-B 7 - ST 4 - BC-C For Example : If the candidate belongs to BC-A 8. Local/ Non-Local Code 9. Handicapped Status Code Code 1 - Local 1 - Visually Handicapped Percentage of Handicapped : 2 - Non-Local 2 - Hearing Impaired a) above 40% b) below 40% The maximum length of study from 4th to 10th class is the criteria for local / Non-local candidate 3 - Orthopaedically Handicapped If the candidate Percentage is above 40% For Example : If the Candidate is Local For Example : If the Candidate is Hearing impaired 10. Qualifications (B) Codes for Professional qualifications 11. Experience and Extra curricular activity if any: (A) Codes for General: (1) B.Ed., 1. Having experience - 1 2. No experience - 2 Candidate should enclose the proofs with duplicate ICR form (1) - B.A., (2) - B.Sc., (3) - B.Com., (4) Oriental Title (equivalent to Degree) (5) PG Course For Example: If a person qualification is B.Com., 12. Weightage of Marks: For Example: a) Satisfactory teaching experience in Govt. / Govt. Res. /Aided Schools: 5 marks (one mark per year to maximum of 5 marks) If candidate having 7 years experience (maximum 5) b) Games & Sports Prize winners: (1st, 2nd & 3rd Prizes) District level - 1 mark , State Level - 2 marks, National Level - 3 marks Subject to a maximum of 10 marks If candidate win 1st prize at National level c) NSS : District level Camps - 1 mark, State Level Camps - 2 Marks, National Level - 3 Marks If candidate win 3rd prize at State level d) NCC: 'B' certificate - 1 mark, 'C' certificate - 2 marks 'C' certificate with participation in Republic day Parade / Army attachment camp / Paratroping - 3 marks If candidate having 'C' Certificate Candidate should enclose relevant attested copies of certificates with the duplicate ICR form. Application will not be considered under any circumstances without enclosing the copies of certificates. 2 1 2 a 3 5 3 2 2 Rs.125/- ORIGINAL TRIBAL WELFARE DEPARTMENT RECRUITMENT FOR THE POST OF HOSTEL WELFARE OFFICER Gr-II (Men and Women on Contract basis) (ICR Application form for Computerization Purpose) Application Number (Office use to be filled by the verification officer) District Code (To be filled by the Candidate as per the Instructions given on the backside of this sheet) 01. Category of the Post 02. Surname Name 03. Father's Name 04. Postal Address Day Month Year Months Years 05. Date of Birth Age: 06. Sex 07. Community 08. Local / Non Local 09. Handicapped Status percentage 10. Education Qualifications: (A) General qualification: (B) Professional Qualification: 11. Experience and Extra Curricular activity if any: 12. Weightage marks: a) Experience b) Games & Sports: c) NSS : d) NCC: 13. Examination: (Date, Time and Center name will be communicated through Hall Ticket) 14. Particulars of D.D.(Rs.125/-) DD. No. Dated. Drawn on which bank I hereby declare that the information furnished here is true and shall be liable for any false information. I hereby declare that all information furnished by the candidate is checked by me and found correct Full signature of the applicant within the box Signature of the Verification officer within the box Date: Date: Paste the latest Pass Port Size photograph strictly within the dotted lines only. Do not staple/ pin or do not sign on the photograph 0 2 PIN Code -11-2007 Instructions for fillingup of ICR APPLICATION FORM FOR COMPUTERIZATION PURPOSE 1. The original application form for computerization purpose shall be handled carefully. It should not be mutilated or folded. Mutilated or folded forms will not be accepted. 2. All the enclosures should be tagged or stapled ONLY TO THE DUPLICATE APPLICATION 3. Applications should be filled properly and legibly by the candidate in his/ her own handwriting with ball pen blue or black in CAPITAL LETTERS only. 4. Please do not overwrite on the original application form. Candidates are advised to make use of the specimen copy of the application form (furnished in the application set) before filling the original ICR application form for computerization purpose. After making sure that the entries made in the specimen are correct. The same can b transferred on to the original form. 5. Only good quality black and white passpost size photograph should be pasted on the original form. Please do not staple or pin the photograph. Please do not sign on the photograph. 6. Only codes should be entered in the boxes provided against items 01,02,03,08,09,10,11 and 12 in the application form. 7. D.D. Rs. 125/- drawn infavour of Asst. Accounts Officer, O/o Director of Tribal Welfare, A.P., Hyderabad (Except in case of SCs / STs) . District Code - 04. East Godavari 09. Nellore 14. Mahaboobnagar 19. Adilabad Code 05. West Godavari 10. Chittoor 15. Ranga Reddy 20. Karimnagar 01. Srikakulam 06. Krishna 11. Kadapa 16. Hyderabad 21. Warangal 02. Vizianagaram 07. Guntur 12. Anantapur 17. Medak 22. Khammam 03. Visakhapatnam 08. Prakasam 13. Kurnool 18. Nizamabad 23. Nalgonda 01. Category of the Hostel Welfare Officer Gr.II 06. Sex Code 07. Community Code Code 1 - Male 1 - OC 5 - BC-D 2 - Female 2 - BC-A 6 - SC 02 - Contract 3 - BC-B 7 - ST 4 - BC-C For Example : If Male For Example : If the candidate belongs to BC-A 8. Local/ Non-Local Code 9. Handicapped Status Code Code 1 - Local 1 - Visually Handicapped Percentage of Handicapped : 2 - Non-Local 2 - Hearing Impaired a) above 40% b) below 40% The maximum length of study from 4th to 10th class is the criteria for local / Non-local candidate 3 - Orthopaedically Handicapped If the candidate Percentage is above 40% For Example : If the Candidate is Local For Example : If the Candidate is Hearing impaired 10. Qualifications (B) Codes for Professional qualifications 11. Experience and Extra curricular activity if any: (A) Codes for General: (1) B.Ed., a. Having experience - 1 b. No experience - 2 Candidate should enclose the proofs with duplicate ICR form (1) - B.A., (2) - B.Sc., (3) - B.Com., (4) Oriental Title (equivalent to Degree) (5) PG Course For Example: If a person qualification is B.Com., 12. Weightage of Marks: For Example: a) Satisfactory teaching experience in Govt. / Govt. Res. /Aided Schools: 5 marks (one mark per year to maximum of 5 marks) If candidate having 7 years experience (maximum 5) b) Games & Sports Prize winners: (1st, 2nd & 3rd Prizes) District level - 1 mark , State Level - 2 marks, National Level - 3 marks Subject to a maximum of 10 marks If candidate win 1st prize at National level c) NSS : District level Camps - 1 mark, State Level Camps - 2 Marks, National Level - 3 Marks If candidate win 3rd prize at State level d) NCC: 'B' certificate - 1 mark, 'C' certificate - 2 marks 'C' certificate with participation in Republic day Parade / Army attachment camp / Paratroping - 3 marks If candidate having 'C' Certificate Candidate should enclose relevant attested copies of certificates with the duplicate ICR form. Application will not be considered under any circumstances without enclosing the copies of certificates. 1 2 1 2 a 3 5 3 2 2